<form action = "{$action}" method = "post" name = "loginForm" onsubmit = "return validateRegistration2Form('{$live_path}', this.name)">
    <div class = "unocart_register">
        <table>
            <tr>
                <td width = "115">
                    {$smarty.const._UNOCART_REG_TITLE} *
                </td>
                <td>
                    {$select_titles}
                </td>
            </tr>
            <tr>
                <td width = "115">
                    {$smarty.const._UNOCART_F_NAME} *
                </td>
                <td>
                    <input type = "text" name = "f_name" id = "f_name" class = "inputbox" value = "{$adv_user->f_name}" />
                </td>
            </tr>
            <tr>
                <td>
                    {$smarty.const._UNOCART_L_NAME} *
                </td>
                <td>
                    <input type = "text" name = "l_name" id = "l_name" value = "{$adv_user->l_name}"  class = "inputbox" />
                </td>
            </tr>
            <tr>
                <td>
                    {$smarty.const._UNOCART_FIRMA_NAME}
                </td>
                <td>
                    <input type = "text" name = "firma_name" id = "firma_name" value = "{$adv_user->firma_name}"  class = "inputbox" />
                </td>
            </tr>
            <tr>
                <td>
                    {$smarty.const._UNOCART_EMAIL} *
                </td>
                <td>
                    <input type = "text" name = "email" id = "email" value = "{$adv_user->email}" class = "inputbox" />
                </td>
            </tr>
            <tr>
                <td width = "115">
                    {$smarty.const._UNOCART_STREET_NR} *
                </td>
                <td>
                    <input type = "text" name = "street" id = "street" value = "{$adv_user->street}" class = "inputbox" />
                </td>
            </tr>
            <tr>
                <td>
                    {$smarty.const._UNOCART_ZIP} *
                </td>
                <td>
                    <input type = "text" name = "zip" id = "zip" value = "{$adv_user->zip}" class = "inputbox" />
                </td>
            </tr>
            <tr>
                <td>
                    {$smarty.const._UNOCART_CITY} *
                </td>
                <td>
                    <input type = "text" name = "city" id = "city" value = "{$adv_user->city}" class = "inputbox" />
                </td>
            </tr>
            <tr>
                <td>
                    {$smarty.const._UNOCART_STATE} *
                </td>
                <td>
                    <input type = "text" name = "state" id = "state" value = "{$adv_user->state}" class = "inputbox" />
                </td>
            </tr>
            <tr>
                <td>
                    {$smarty.const._UNOCART_COUNTRY} *
                </td>
                <td>
                    {$select_countries}
                </td>
            </tr>
            <tr>
                <td width = "115">
                    {$smarty.const._UNOCART_TELEFON} *
                </td>
                <td>
                    <input type = "text" name = "phone" id = "phone" value = "{$adv_user->phone}" class = "inputbox" />
                </td>
            </tr>
            <tr>
                <td>
                    {$smarty.const._UNOCART_FAX}
                </td>
                <td>
                    <input type = "text" name = "fax" id = "fax" value = "{$adv_user->fax}" class = "inputbox" />
                </td>
            </tr>
        </table>
    </div>
    {$smarty.const._UNOCART_DELIVERY_ADRESS}
    <input type = "radio" name = "delivery_adress" id = "delivery_adress_1" value = "0" {if !$delivery_adress} checked = "checked" {/if} onclick = "jQuery('#div_delivery').hide()" />
    <label for = "delivery_adress_1">{$smarty.const._UNOCART_NO}</label>
    <input type = "radio" name = "delivery_adress" id = "delivery_adress_2" value = "1" {if $delivery_adress} checked = "checked" {/if} onclick = "jQuery('#div_delivery').show()" />
    <label for = "delivery_adress_2">{$smarty.const._UNOCART_YES}</label>
    <div id = "div_delivery" class = "unocart_register" {if !$delivery_adress}style = "display:none"{/if}>
        <table>
            <tr>
                <td width = "115">
                    {$smarty.const._UNOCART_REG_TITLE} *
                </td>
                <td>
                    {$select_d_titles}
                </td>
            </tr>
            <tr>
                <td width = "115">
                    {$smarty.const._UNOCART_F_NAME} *
                </td>
                <td>
                    <input type = "text" name = "d_f_name" id = "d_f_name" class = "inputbox" value = "{$adv_user->d_f_name}" />
                </td>
            </tr>
            <tr>
                <td>
                    {$smarty.const._UNOCART_L_NAME} *
                </td>
                <td>
                    <input type = "text" name = "d_l_name" id = "d_l_name" value = "{$adv_user->d_l_name}"  class = "inputbox" />
                </td>
            </tr>
            <tr>
                <td>
                    {$smarty.const._UNOCART_FIRMA_NAME}
                </td>
                <td>
                    <input type = "text" name = "d_firma_name" id = "d_firma_name" value = "{$adv_user->d_firma_name}"  class = "inputbox" />
                </td>
            </tr>
            <tr>
                <td width = "115">
                    {$smarty.const._UNOCART_STREET_NR} *
                </td>
                <td>
                    <input type = "text" name = "d_street" id = "d_street" value = "{$adv_user->d_street}" class = "inputbox" />
                </td>
            </tr>
            <tr>
                <td>
                    {$smarty.const._UNOCART_ZIP} *
                </td>
                <td>
                    <input type = "text" name = "d_zip" id = "d_zip" value = "{$adv_user->d_zip}" class = "inputbox" />
                </td>
            </tr>
            <tr>
                <td>
                    {$smarty.const._UNOCART_CITY} *
                </td>
                <td>
                    <input type = "text" name = "d_city" id = "d_city" value = "{$adv_user->d_city}" class = "inputbox" />
                </td>
            </tr>
            <tr>
                <td>
                    {$smarty.const._UNOCART_STATE} *
                </td>
                <td>
                    <input type = "text" name = "d_state" id = "d_state" value = "{$adv_user->d_state}" class = "inputbox" />
                </td>
            </tr>
            <tr>
                <td width = "115">
                    {$smarty.const._UNOCART_TELEFON} *
                </td>
                <td>
                    <input type = "text" name = "d_phone" id = "d_phone" value = "{$adv_user->d_phone}" class = "inputbox" />
                </td>
            </tr>
        </table>
    </div>
    {if $register}
        <div class = "unocart_register">
            <input type = "checkbox" name = "agb" id = "agb" />
            {$agb}
        </div>
        <input type = "hidden" name = "option" value = "com_unocart" />
        <input type = "hidden" name = "task" value = "checkout" />
        <input type = "hidden" name = "step" value = "3" />
        <input type = "hidden" name = "Itemid" value = "{$smarty.request.Itemid}" />
    {else}
        <input type = "hidden" name = "task" value = "save_account" />
    {/if}
    <br />
    <input type = "submit" name = "next" value = "{$submit_text}" class = "button" />
</form>